2015 NPC Diamond Classic - NATIONAL QUALIFIER Bodybuilding - Figure - Bikini & Physique Sanctioned by the NPC of the U.S.A # 1 4 0 5 2 2015 NPC DIANOND BODYBUILDING, FITNESS, FIGURE AND BIKINI CLASSIC, OFFICIAL ENTRY FORM (THIS IS A DRUG TESTED EVENT- 2 YEARS DRUG FREE FOR BODYBUILDING) NO SATURDAY CHECK-IN NPC ATHLETE CHECK-IN & REGISTRATION: FRIDAY APRIL 24th Mandatory check-in for all pre-registered athletes. At the Hilton of Boca Raton 7920 Glades Road - (Check at Hotel front desk) 6:00pm to 8:00pm. Walk-up registrations welcome (late fee applies). SATURDAY CHECK – IN FOR MEETING @ 8:30AM : OLYMPIC HEIGHTS COMMUNITY HIGH SCHOOL, 20101 LYONS ROAD, BOCA RATON, FL FOR ALL COMPETITORS – IF YOU MISS THIS MEETING YOU WILL NOT COMPETE.– PUBLIC PRE-JUDGING BEGINS AT 9:30AM – PUBLIC EVENING SHOW: 6:30PM. APRIL 25TH, 2015. MAIL ENTRY FORM (By due date of April 17 QC-BB PROMOTIONS, INC. P.O. Box 880171 BOCA RATON, FL 33488-0171 TEL: 561-376-9849 th, 2015) TO: TOP 5 TROPHY AWARDED FOR EVERY CLASS TOP 6 FOR BIKINI th th DEALINE: All entries must be received on or before April 17 , 2015. Late walk-ins & late entries received after April 17 will pay $150.00 to register (CASH ONLY – NO EXCEPTIONS) I www.DiamondBodybuildingClassic.com Please enter me in the following contest (check appropriate contest): ENTRY FEE: $75.00 MEN’S OPEN BODYBUILDING ___Lightweight Class (154 ¼ & under) ___Middleweight Class (Above 154¼ to 176 ¼) ___Lightheavyweight Class (Above 176 ¼ to 198 ¼) ___Heavyweight Class (Above 198 ¼ ) MEN’S BODYBUILDING MASTERS ___ Over 35 ___ Over 40 ___ Over 50 ___ Over 60 MEN’S TEEN BODYBUILDING ___ One Class MEN’S NOVICE BODYBUILDING ___ One Class WOMEN'S FIGURE NOVICE ___ One Class BIKINI NOVICE (NEW, 3 Classes) ___ Class A (Up to & including 5'4") ___ Class B (Over 5'4" & including 5'6") ___ Class C (Over 5'6") WOMEN’S PHYSIQUE OPEN __ Class A (Up to 5'6" ) __ Class B (Over 5'6") WOMEN’S PHYSIQUE MASTERS OVER 30 __ One Class BIKINI OPEN ___Class A (5’2” & under) ___Class B (Above 5’2” up to including 5’4”) ___Class C (Above 5’4” to 5' 6") ___Class D (Over 5'6") MEN’S PHYSIQUE __ Class A (Up to & including 5’7”) __ Class B (Above 5'7" up to & including 5’10”) __ Class C (Over 5’10”) MEN'S PHYSIQUE NOVICE (NEW, 2 Classes) __ Class A (Up to & including 5'8" ) __ Class B (Over 5'8") MEN'S TEEN PHYSIQUE __ One Class MEN'S PHYSIQUE MASTERS (Over 40) __ One Class WOMEN’S OPEN FIGURE ___Class A (5’2” & under) ___Class B (Above 5’2” up to including 5’4”) ___Class C (Above 5’4” to 5"6") ___Class D (Over 5'6") WOMEN'S FIGURE OVER 30 ___ One Class WOMEN'S FIGURE OVER 40 ___ One Class WOMEN'S FIGURE OVER 50 ___ One Class BIKINI OVER 30 ___ Over 30 (One Class) BIKINI OVER 40 ___ Over 40 (One Class) Note: All bodybuilding contestants will be officially weighed in (see times above) in their posing suits and their exact weight class the assigned. CROSSOVER: Athletes may enter one or other contest in addition to their primary event, this fee is $50.00. (Subject to their being qualified). Athletes may not enter more than one age group in the same category. Crossovers are permitted between Figure, Bikini, Men’s Physique and Bodybuilding. NAME: ______________________________________________________________________AGE: _____________ WEIGHT: ___________ HEIGHT: __________________ YEARS TRAINED:________________________ STREET ADDRESS: _______________________________________ APT. #: ________ CITY: _________________________ STATE: _________________ ZIP: ______________ TELEPHONE (_____) ____________________________ NPC CARD #: _____________________________ Do you currently hold a valid 2015 NPC card Yes No OCCUPATION:______________________________________________ (If No, can be purchased at the of check-in FRIDAY April 24th) TEAM/CLUB/GYM AFFILIATION: _____________________________________ HOBBIES: __________________________________________________________________ PAST CONTESTS ENTERED & RESULTS: __________________________________________________ ____________________________________________________________________________________ E-MAIL: _________________________________________________________________ In consideration of being allowed to participate in any way in the DIAMOND CLASSIC (“Event”) promoted by Andres Miller, QC-BB Promotions, Inc., (“Promoter”) and sanctioned by the National Physique Committee of the USA, Inc. (“NPC”), its related events and activities, I, Athlete_____________________________________________________), the undersigned, acknowledge, appreciate and agree that: The risk of injury from the activities involved in this Event is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, I KNOWLINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE PROMOTER AND/OR THE NPC or others, and assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation, if, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Promoter immediately; and I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE PROMOTER AND THE NPC and each of their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used for the activity (“Releases”), WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH, or loss or damage to person or property associated with my presence at or participation in or in traveling to and from the Event, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. The undersigned further consents and agrees that the undersigned will comply with all rules and regulations of the HILTON HOTEL (“Hotel”) including any rules or regulations prohibiting cooking or food preparation in the hotel rooms. The undersigned further agrees that the undersigned will indemnify and hold harmless the NPC and the Promoter from and against any damages caused by the undersigned to the Hotel or damages to a guest room or rooms occupied or registered to the undersigned. Finally, the undersigned acknowledges that the undersigned’s failure to comply with any rule or regulation of the Hotel or damage to any guest room occupied by or registered to the undersigned may result in disciplinary action against the undersigned including, but not limited to, suspension as a member of the NPC and/or competing in contests sanctioned by the NPC. And in further consideration of permission being granted to me to participate in the Event and its related events. I hereby grant the NPC, Promoter and/or any other NPC-approved video or entertainment organization and all of their agents, successors, licensees and assigns, the right to photograph or otherwise reproduce (whether by film, tape, still photography or otherwise) my voice, appearance and name, and to exhibit, distribute, transmit, and/or otherwise exploit any and all media, including without limitation, by means of still photography, motion pictures, radio, television, television motion pictures, video, printing on digital or any other medium now known or hereafter devised, including with respect also to any merchandising, advertising and/or publicity, and the right to use my name and information about me in any connection with any of the foregoing. The rights granted by me hereunder are granted for the entire universe and shall endure in perpetuity and no further compensation shall be payable to me at any time in connection therewith. Nothing contained herein shall be deemed to obligate the NPC, Promoter, and/or any other NPC-approved video or entertainment organization, to photograph or otherwise reproduce my voice, appearance or name, or to make use of any rights granted herein. I also understand that the aforementioned rights may be reassigned at any time without further consent. I understand that the NPC, the Promoter and/or any NPC-approved video or entertainment organization, are videotaping and photographing the Event in express reliance upon the foregoing, and I represent and agree that I am free to grant the rights granted to the NPC, Promoter and/or any other NPC-approved video or entertainment organization hereunder. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. X____________________________________________________________ Age: __________ Date Signed:___________________________________ PARTICIPANTS SIGNATURE FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releases from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law. X_____________________________________________________________ Age:________ Date____________________2015 Signed:________________________________________________________ PARTICIPANTS SIGNATURE GLOWING GOLD - OFFICIAL TANNING COMPANY OF THE DIAMOND CLASSIC CALL AND BOOK YOUR APPOINTMENT @ 305-826-4653 www.glowinggold.com EARLY BIRD SPECIAL PRICING AND 10 DAYS FREE UV TANNING